At this point, Pienta explains, the only 2 FDA-approved drugs are abiraterone and sipuleucel-T. Pienta prefers sipuleucel-T when the patient has only mild symptoms and rapid progression is not a concern. As an adjunctive therapy, I can also use an anti-osteoclast therapy, like zoledronic acid.

Since there is no way to measure the short-term effect of sipuleucel-T, Pienta only uses the treatment when the patient can tolerate being off cytotoxic therapy for 3 months while they prepare for, receive the therapy, and then recover from the therapy.